Type 1 Basal insulin

[MrsC93]

Hi guys, was wondering if yous could help me please?

My blood sugars are pretty stable through the day and night, but in the morning between 6am - 12pm is my worst time for huge peaks, it's a gradual spike even after breakfast, around lunch is perfect.
I take two doses of levemier through the day at 12pm and 10pm, what dose would be better adjusted the one mid day? Or the one in the evening?

Many thanks!

 

[Deleted member 527103]

I would be concerned about increasing your basal if your level are ok most of the day and you are trying to manage a rise in the morning as it could lead to hypos later. What you are experiencing may have nothing to do with basal but may be one (or both) of a couple of things

- Foot on The Floor - our livers are really helpful. They dump glucose into our blood to give us energy to start the day. Some of us experience a blood sugar high due to this before we wake up. This is Dawn Phenomenon. Other livers wait until they see us get up (put our foot on the floor) and then start to dump glucose. This is referred to as Foot on The Floor. With an insulin pump, you can adjust your basal to manage that extra glucose. With MDI, it is more challenging but if you experience Foot On The Floor, you can bolus to manage it.

- Morning insulin resistance - many of us find our bodies are more resistant to insulin at different times of the day. Typically, mornings have most insulin resistance. Therefore, our insulin to carb ratio needs to be higher when dosing for breakfast than at other times of the day.

 

[MrsC93]

I would be concerned about increasing your basal if your level are ok most of the day and you are trying to manage a rise in the morning as it could lead to hypos later. What you are experiencing may have nothing to do with basal but may be one (or both) of a couple of things

- Foot on The Floor - our livers are really helpful. They dump glucose into our blood to give us energy to start the day. Some of us experience a blood sugar high due to this before we wake up. This is Dawn Phenomenon. Other livers wait until they see us get up (put our foot on the floor) and then start to dump glucose. This is referred to as Foot on The Floor. With an insulin pump, you can adjust your basal to manage that extra glucose. With MDI, it is more challenging but if you experience Foot On The Floor, you can bolus to manage it.

- Morning insulin resistance - many of us find our bodies are more resistant to insulin at different times of the day. Typically, mornings have most insulin resistance. Therefore, our insulin to carb ratio needs to be higher when dosing for breakfast than at other times of the day.

Yes, for years I have had all of the above from dawn phenomenon, insulin resistance s and I would imagine my liver dumps glucose into the blood stream as well, I was just hoping the correct amount of basal at the correct time would stop me peaking. My blood sugar could be at 7 all night and by 10am it would be at 14, then by lunch back down at 7, I have to take 3 times the amount of insulin for breakfast. It is so draining

Thanks for the reply

 

[Deleted member 527103]

Yes, for years I have had all of the above from dawn phenomenon, insulin resistance s and I would imagine my liver dumps glucose into the blood stream as well, I was just hoping the correct amount of basal at the correct time would stop me peaking. My blood sugar could be at 7 all night and by 10am it would be at 14, then by lunch back down at 7, I have to take 3 times the amount of insulin for breakfast. It is so draining

Thanks for the reply

When do you take your bolus?
If your blood sugars return to 7, it suggests to me that you need to take your breakfast bolus earlier.
Have you tried Fiasp? It is faster acting than NovoSluggish or Humalog.

 

[MrsC93]

When do you take your bolus?
If your blood sugars return to 7, it suggests to me that you need to take your breakfast bolus earlier.
Have you tried Fiasp? It is faster acting than NovoSluggish or Humalog.

Yes, I think I'm gonna have to play about with it and tweak it a bit , 12pm and then 10pm, I have a baby so morning times aren't in routine atm, so maybe that is the problem. I've had lantus, troshiba and on Levemier atm.

Thanks for taking the time to give some advice